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Home Health Agency (HHA) Center

Spotlights
  • Jimmo v. Sebelius Settlement Agreement (Fact Sheet) - On January 24, 2013, the U. S. District Court for the District of Vermont approved a settlement agreement in the case of Jimmo v. Sebelius.  For additional information, please see the Jimmo v. Sebelius Settlement Agreement Fact Sheet.

  • Temporary Delay in Implementing Ordering and Referring Denial Edits 
    Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed. These edits would have checked the following claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National Provider Identifier (NPI). If either of these were missing or incorrect, claims would deny.  

    • Medicare Part B claims from laboratories, imaging centers and Durable Medical Equipment, Orthotics, and Supplies (DMEPOS) that have an ordering or referring physician/non-physician provider; and  
    • Part A Home Health Agency (HHA) claims that require an attending physician provider. 

    CMS will advise you of the new implementation date in the near future. In the interim, informational messages will continue to be sent for those claims that would have been denied had the edits been in place.  For more information, see the revised article  SE1305 – Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims.

  • On March 1, 2013 CMS released updated face-to-face encounter Q&As and therapy Q&As to provide guidance for physicians, non-physician practitioners, physician support personnel, and home health agencies on compliance with the face-to-face encounter and therapy reassessment requirements, including the changes to those policies that were made in the CY 2013 Home Health Prospective Payment System Refinements and Rate Update, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies Final Rule (CMS-1358-F).
  • CY 2013 Home Health Prospective Payment System Refinements and Rate Update, Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies (CMS-1358-F).  A final rule was displayed at the Federal Register to update Medicare's Home Health Prospective Payment System (HH PPS) payment rates for Calendar Year (CY) 2013.  Payments to home health agencies (HHAs) are estimated to decrease by approximately 0.01 percent, or -$10 million in CY 2013, reflecting the combined effects of the home health payment update ($260 million increase), wage index updates ($70 million decrease), a new FDL ratio ($50 million increase), and reductions to the HH PPS to account for a 1.32 percent case-mix coding adjustment ($250 million decrease).  The rule also rebases and revises the home health market basket, allows additional regulatory flexibility regarding therapy documentation and reassessments as well as face-to-face encounter requirements, discusses the transition plan for ICD-10, and provides information on the home health study concerning home health care access.  Lastly, this rule implements new requirements concerning the hospice quality reporting program and will establish requirements for unannounced, standard, and extended surveys of home health agencies (HHAs) and provide a number of alternative (or intermediate) sanctions that could be imposed if HHAs were out of compliance with Federal requirements.  The provisions in this final rule are effective for episodes ending on or after January 1, 2013, unless otherwise specified in the final rule.  For episodes that begin in CY 2012 and end in CY 2013, the therapy provisions of this final rule do not apply.  The therapy provisions of this final rule are applicable to episodes that begin on or after January 1, 2013.
  • Vaccination is the Best Protection Against the Flu [PDF, 414KB]
  • HHA VBP Report to Congress - The Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing (VBP) program for payments under the Medicare program for home health agencies (HHAs). The Secretary shall submit the report containing this plan to Congress.

    The Report to Congress describes the current efforts to improve quality and payment efficiency in HHAs. In addition, it considers the steps required in designing and implementing an HHA VBP program for payments under the Medicare program. CMS views VBP as an important step forward in revamping how Medicare pays for health care services; moving the program towards rewarding better value, outcomes, and innovations, instead of merely volume.

    The HHA VBP Report to Congress was authorized under Section 3006(b) of the Patient Protection and Affordable Care Act (Pub. L. 111-148), enacted on March 23, 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), enacted on March 30, 2010 (collectively known as the Affordable Care Act) (as added by section 10301(a) of the Affordable Care Act).

 

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